﻿<table style="text-align: left; border="0" cellpadding="0" cellspacing="0">
<tr valign=top>
<td width="328px" height="214px" background="img/sys/regcard_front.jpg">
  <table border=0 cellpadding="0" cellspacing="0">
    <tr height=75px><td colspan=2>&nbsp</td></tr>
    <tr height="27px" valign=bottom><td width="95px" align="right" >&nbsp</td><td><font face="angsana upc" size=2> {0}</font></td></tr>
    <tr height="27px" valign=bottom><td align="right" >&nbsp</td><td><font face="angsana upc" size=2> {1}</font></td></tr>
    <tr height="26px" valign=bottom><td align="right" >&nbsp</td><td><font face="angsana upc" size=2> {2}</font></td></tr>
    <tr height="27px" valign=bottom><td align="right" >&nbsp</td><td><font face="angsana upc" size=2> {3}</font></td></tr>
  </table>
</td>
<td width="328px" height="214px" background="img/sys/regcard_back.jpg" valign=top>
  <table border="0" cellpadding="0" cellspacing="0">
    <tr height=27px><td colspan=5>&nbsp</td></tr>
    {4}
  </table>
</td>
</tr>

</table>